| NPI | 1578606869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE BRITT Credentialing Coordinator 321-725-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |